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GAO discussed the effectiveness of the nation's organ procurement and allocation system. GAO noted that: (1) organ procurement organizations need to consider factors such as the likelihood of a successful transplant, how urgently a transplant is needed, and length of time on the waiting list when allocating the limited supply of organs; (2) 25 of 68 organ procurement organizations have altered the United Network for Organ Sharing's (UNOS) criteria when ranking potential recipients; (3) some organ procurement organizations have narrowed their pool of potential recipients to a particular transplant center, rather than considering potential recipients from all area transplant centers, which is inconsistent with federal law requiring equitable distribution of organs; (4) there have been variations in the documentation of patients not selected for the organ transplants at 10 organ procurement organizations; (5) the Department of Health and Human Services needs to develop compliance policies for organ procurement organizations and transplant centers; (6) the Health Resources and Services Administration (HRSA) and UNOS do not monitor the organizations' procurement efforts or have an appropriate measure for assessing procurement effectiveness; and (7) HRSA and UNOS do not systematically target technical assistance to organ procurement organizations that may need help obtaining donors.